Saturday 23 January

As the week began, the NHS said to be in its most precarious situation ever, anti-lockdown Lord Sumption stirred up another storm by suggesting some lives (in this case a cancer sufferer) are worth less than others. Although many are rightly horrified by his Darwinist stance, hard decisions are already having to be made in the severely strained NHS because ICUs don’t have the capacity for all patients needing that level of care. We can hope that BBC News at Ten’s regular coverage of ICUs will have convinced any Covid denying viewers of what’s really at stake, exhausted staff regularly breaking down and it taking up to eight clinicians to turn a patient, seen as one of the most helpful interventions for facilitating breathing.

We may have thought the daily Covid death totals couldn’t get any worse, but no: this week we’ve seen shocking numbers – 1610 on Tuesday, 1820 on Wednesday, 1290 on Thursday and 1348 on Saturday. Sceptics may be forgiven for thinking the latest evidence (so far not conclusive) that the new variant, besides being much more transmissible, is also more deadly, has come at a convenient time for the Prime Minister. It’s not the first time he’s appeared to blame the virus rather than the incompetence of his administration. There’s a danger of these terrible statistics becoming normalised, in fact it seems it’s already happening when you hear the matter of fact way such news is conveyed by the media. On Wednesday palliative care doctor Rachel Clarke tweeted: ‘No. Another *1820* UK Covid deaths. This figure makes me want to weep, scream, punch a wall, smash furniture. As if the deaths alone weren’t devastating, knowing many were avoidable crushes me. These are mass casualties caused by failure of government. Heartbreaking.’

The FT’s Chris Giles has been conducting a regular analysis of the Office for National Statistics figures (England and Wales) and reckons ‘the number of UK excess deaths linked to Covid since mid March 2020 has surpassed a new grim milestone of 106,300. Of these, 94,745 have been recorded officially, the remainder are estimates’. As if care homes, their residents and families haven’t already suffered enough, another source pointed up ONS data on care home deaths: ‘another 1,370 care home residents in England and Wales were registered to have died with Covid-19 in the first week of January. To those who say “these people would have died anyway” – deaths were 46% above the 5 year average for that week’.

Early in the week it looked as if there could be some splitting amongst ministers rather than the usual united front. The decision (after 10 months) to close travel corridors and require negative tests for those entering the UK prompted Priti Patel to disclose that back in March she had advocated closing the UK’s borders but was overruled. That this wasn’t done back then has obviously played a major part in what we’re up against over 10 months later. Yet current photos and passenger reports of a packed Heathrow show there is still very little evidence of Covid safety practice there. The Guardian’s John Crace accurately captures the Home Secretary’s skill at filling airspace with soundbites and statements of the obvious while saying precisely nothing. ‘….earlier this week – perhaps anticipating a messy and damaging public inquiry – she had knifed Johnson in the back by claiming she had wanted stricter border controls back in March but had been overruled by the prime minister. So she ignored that bit of the question and went back on to repeat. We were in the middle of a terrible pandemic. The vaccine was a good thing. It was far too early to say when the lockdown would end etc etc. She did much the same when asked whether people should think about booking summer holidays. We were in the middle of a terrible pandemic. The vaccine was a good thing. It was far too early to say when the lockdown would end and people should be concentrating on staying home rather than thinking of travelling. And by the way the emergency services were doing an excellent job’.

In the context of death totals and the need for adhering to lockdown restrictions Health Secretary Matt Hancock infuriated some by telling the public: ‘Don’t blow it now. We are on the route out’. One Downing Street briefing viewer tweeted: Matt Hancock ‘Don’t blow it now. We are on the route out”. You blew it: by letting people with Covid into the UK for 11 months with your disastrous app with your haphazard, late lockdowns with your mixed Christmas messages by failing to remove Cummings’. Another said: ‘How rich of Matt Hancock instructing the public not to ‘blow it’ when his government has consistently ‘blown it’ since March’. Many will have been dismayed (after nearly a year of this lockdown hokey cokey) that lockdown could continue until the summer and that hospitality won’t be allowed to open until May. I wouldn’t put it past this government, though, to put this worse case scenario message out there so that people will then fall over themselves in gratitude and forget the terrible mistakes made if it ends sooner.

Meanwhile, environmentalist George Monbiot, having already written about the government’s lack of exit strategy from lockdown, now focuses on what’s increasingly coming centre stage: the lingering and costly effects of Long Covid and the need for the government to take this seriously. ‘Perhaps to a greater extent than at any point since the first world war, we find that our lives do not matter to those who govern us. Boris Johnson scarcely seeks to disguise his insouciance and callousness. He hardly mentions the astonishing death toll caused by his mishandling of the pandemic: to acknowledge it would be to acknowledge his responsibility. But not only the dead are missing from his moral atlas. So are those with long-term conditions caused by Covid-19. They are likely, already, to number in the tens of thousands. If Johnson eases restrictions when most older people have been vaccinated, there could be tens of thousands more…’.

Monbiot likens the range of possible mental, physical and neurological symptoms to those accompanying Chronic Fatigue Syndrome, whereby any exertion can make the sufferer unwell, leading to such a low quality of life that one study placed it lower on the scale than cancer, stroke, schizophrenia and MS. ‘Many sufferers are confined to their home or even their bed, with their working life, social life and family life truncated. There is, so far, no diagnostic test and no cure. As for ME, Monbiot makes a plea for quality research on Covid and its funding, especially as Long Covid clinics are already making mistakes. ‘We need massive research programmes into both long Covid and ME/CFS, coupled with better information for doctors. But above all, we need something that currently seems a long way off. A government that gives a damn’.

Following on from last week, more problems are emerging with the much flaunted (world beating) vaccination programme, including issues with supplies meaning some are being diverted to other parts of the country; those vaccinators quite rightly sticking to the original dosing advice being threatened with having their licenses removed; the news that yet another crony contract has been discovered to be at work; continuing debates as to which groups should be prioritised (seems a no brainer to vaccinate teachers,  police officers and supermarket workers); insufficient public awareness that one dose doesn’t equate to ‘vaccination’ so many older people believe they can now see their grandchildren, go on holiday etc; and continuing ignorance and/or collusion of the media in not making these issues clear although this is finally improving on some BBC programmes. But the main debate is still the so called ‘public health decision’ to delay the second dose of the Pfizer vaccine for three months after the first, contrary to Pfizer instructions, to the approval process and to World Health Organisation and other bodies’ advice. It’s shameful that so many key spokesmen, primarily Chris Whitty and Patrick Vallance, have allowed themselves to be caught in the government’s PR net, artificially inflating the numbers of those ‘vaccinated’. Various experts have questioned this and now the British Medical Association has written to Professor Whitty, a letter seen by the BBC, to express its marked disquiet over this decision.

‘The doctors’ union said the UK approach “has become increasingly isolated internationally” and “is proving ever more difficult to justify…The absence of any international support for the UK’s approach is a cause of deep concern and risks undermining public and the profession’s trust in the vaccination programme…’. On BBC Breakfast BMA chair, Dr Chaand Nagpaul, raised ‘growing concerns’ that the vaccine could become less effective when doses are 12 weeks apart.

Data from Israel, which is leading the world on mass vaccination, suggested that effectiveness could be as low as 33 per cent after a first dose. Vallance insisted it was likely to be higher but accepted it would probably be lower than the 89 per cent suggested by the government in justifying the switch in strategy last month. Communities Secretary Robert Jenrick defended it on Sky News, claiming that it was based on ‘advice’ from the regulator and the UK’s four chief medical officers, but it seems clear it’s the other way around: that the government’s decision preceded these experts’ collusion with it. It’s refreshing to see other clinicians lambasting this strategy, including a doctor calling into Radio Four’s Any Answers, who said her respect for Whitty had ‘fallen off a cliff’ because of it. As a listener tweeted: ‘The government vaccination plan is not a plan at all. It is a machine gun scatter and run 1 jab disaster scenario that is going to cost 10s of thousands of lives’. It will be interesting to see what emerges from the BMA intervention, the legal challenge mounted by Dame Joan Bakewell and the petition.

Although it was reassuring, to some extent, to see first dose statistics this week, it was less so to learn that Dominic Raab, on Sky News, had refused ‘to guarantee that everyone will get their second dose within 12 weeks’. One tweeter commented on the verbal gymnastics characterising many of these announcements: ‘…adults to be ‘offered’ the first dose. Stress-inducing, trust-reducing communication as ‘offering’ doesn’t equate to actually getting the dose’. Another interesting angle regarding the second dose delay was raised this week, one consultant suggesting that the change of strategy could invalidate patients’ consent, since this was given on the basis of the original timing. This could have implications for future litigation. The possibility (likelihood?) of vaccination passports has also been discussed, although unlike other countries this government has so far shown itself to have no appetite for creating the infrastructure needed to support necessary measures. It stands to reason that an increasing number of venues will require proof of vaccination before allowing entry and now leading cruise provider Saga has said it will demand it. The Global Tourism Crisis Committee has also said vaccine passports must become essential travel documents in order to restart international tourism. Not surprisingly, some have argued that this would be discriminatory and open to legal challenge, but surely such a crucial measure should be exempt from equalities and discrimination law.

It was only a matter of time before it would emerge that the vaccination programme, like everything else the government touches, had been tainted by cronyism. Now openDemocracy has revealed the role of Tory donor Lord Ashcroft, whose company Medacs Healthcare has been given a £350m contract to source staff for the programme. Hearing about a friend’s husband’s experience this week made me wonder if his vaccinator was one of them – when the injection site started bleeding, the vaccinator, who looked about 12,  just stood there and said ‘It’s bleeding’. openDemocracy observes: ‘The award of a major COVID contract to a firm with close ties to the Tories has sparked further questions about politically connected firms benefiting financially from the UK’s pandemic response’. As with the disastrous PPE contracting, the government shows it has learned nothing, once again issuing a major contract not only to a crony but also to a company inexperienced in the area of work concerned. ‘Medacs has previously worked with numerous councils across England but this appears to be the company’s first major COVID contract’. Nothing like giving newcomers a chance, eh? Yet another for Jolyon Maugham’s Good Law Project to investigate.

Meanwhile, the inimitable More or Less on Radio 4 (Monday morning at 11.30 and later on BBC Sounds) will look at different countries’ vaccination poliies and how they decide which groups to prioritise. Besides not yet having prioritised teachers, police officers and supermarket workers, there’s discussion in the UK as to whether those from black and ethnic minority communities should be included because of the clear evidence that they’re more at risk of contracting the virus. This should prove interesting and important listening. On a lighter note, the last five minutes of the last More or Less are especially worth listening to, for a deconstruction of attempts by ministers Penny Mordaunt and Michael Gove to misrepresent the post-Brexit UK fish catch entitlement. It ends with the deconstruction put into sea shanty form.

In more positive news, it came as a relief and joy to many, following threats of Trump supporter insurrection beforehand, that Donald Trump actually left the White House of his own accord and that Joe Biden, his family and supporters were able to enjoy his exhilarating inauguration day. Biden’s pronouncement ‘Democracy has prevailed….this is democracy’s day’ will surely be remembered for a long time to come. It was predictably ominous that Trump said ‘we’ll be back in some form’, but having his social media accounts closed down and key financial donations withdrawn will cramp his style somewhat and the forthcoming impeachment trial might well result in him no longer being eligible to stand for public office. Regarding his numerous controversial pardons issued just hours before the end of his administration, a wag asked if there would be one for Trump’s hairdresser.

However purposeful and mindful we are of the need during these lockdowns to structure our days, keep busy, keep in contact and practice self-care, these January days can feel a bit like a long Groundhog Day. One of the best signs of spring approaching is the sight of snowdrops and crocuses emerging, so hats off to the provider of a virtual snowdrop festival. Whereas the Devon garden boasting different examples of galanthus would normally be seeing many visitors in person, it’s now generously moving its event online (Facebook and Instagram) so many more can benefit. The house and garden sound very interesting in their own right. ‘….. once home to the vicars of Buckland Monachorum, the house and garden trace their history back to 1305 and feature romantic ruins including a tower with a spiral staircase and a thatched barn. A modern vicarage was built in the 1920s and just after the second world war was bought by Lionel Fortescue, a retiring Eton master, and his wife, Katharine, who set about renovating and developing their garden. They bequeathed the house and garden to the Fortescue Garden Trust, an independent charity that continues to run the property.’

Finally, although it seems strange timing it’s cheering to learn that Paignton Picture House in Devon (thought to be the first pupose-built cinema in Europe, opening in 1907) is to be ‘restored to its former glory’, thanks to an English Heritage grant. It was lovely to hear that crime writer Agatha Christie was a regular patron and used to book two seats – one for herself and the other for her butler, who would then serve her drinks during the film. We’re not told whether the butler liked the films or whether he was allowed to have a drink himself!

Published by therapistinlockdown

I'm a psychodynamic therapist in private practice, also doing some voluntary work, and I'm interested in the whole field of mental health, especially how it's faring in this unprecedented crisis we're all going through. I wanted to explore some of the psychological aspects to this crisis which, it seems to me, aren't being dealt with sufficiently by the media or policymakers, for example the mental health burden already in evidence and likely to become more severe as time goes on.

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